Alcohol-induced blackouts (AIBs) are prevalent among college students and are associated with significant adverse outcomes, including an elevated risk of developing alcohol use disorder. As a preventive measure, previous research indicates that protective behavioral strategies (PBS) are effective in reducing alcohol consumption and its negative consequences. PBS is categorized into three types: limiting alcohol consumption, modifying drinking behaviors, and serious harm reduction (SHR). Among these, SHR aims to enhance drinking safety by implementing measures such as utilizing designated drivers and avoiding high-risk situations. However, empirical findings on the effectiveness of SHR in reducing alcohol-related harm remain inconclusive, with most studies conducted on low-risk college student populations. Therefore, this study aims to examine whether SHR mitigates the association between AIBs and both overall alcohol-related negative consequences and severe outcomes among high-risk college students.
The study employed a longitudinal design with 79 college students who regularly engaged in risky drinking behaviors. Participants were selected from a large public university and met specific eligibility criteria, including consuming four or more drinks on a typical weekend night, experiencing at least one alcohol-induced blackout (AIB) in the past semester, and owning an iPhone for data collection purposes. Data were collected over four consecutive weekends, during which participants wore transdermal alcohol sensors and completed daily diary surveys each morning. To analyze the collected data, linear multilevel modeling was conducted to assess the moderating effects of serious harm reduction (SHR) strategies on the relationship between AIBs and alcohol-related negative consequences, controlling for individual differences and within-person variability.
According to the findings, Serious Harm Reduction (SHR) strategies demonstrated a significant moderating effect in mitigating the relationship between alcohol-induced blackouts (AIBs) and total alcohol-related negative consequences. On days with low SHR use, AIB occurrence was associated with an additional 1.46 negative consequences compared to non-AIB days. However, on days with moderate SHR use, this difference decreased to 1.21, and on days with high SHR use, it further reduced to 0.94, suggesting that SHR may help reduce overall alcohol-related negative consequences. In contrast, SHR did not exhibit a significant moderating effect on the relationship between AIBs and serious negative consequences (e.g., sexual assault). This finding indicates that while SHR may be effective in mitigating general alcohol-related harms, it may have limited impact on preventing more severe consequences. Additionally, to account for sample size effects, a Monte Carlo simulation was conducted. The analysis suggested that in a larger sample, SHR might significantly mitigate the relationship between AIBs and serious negative consequences. These findings underscore the need for a more nuanced understanding of SHR’s role in prevention and intervention strategies targeted at high-risk college students and highlight the necessity for further research.
Takeaway: SHR strategies may help mitigate the overall negative consequences of alcohol-induced blackouts (AIBs) among high-risk college students.